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Three good reasons to start this year to participate in PQRS

If you’ve not participated in the Physician Quality Reporting System (PQRS) before, there are three good reasons to start this year.

First, there’s still money to be earned. Yes, I know that the PQRS incentive has dropped from 2% of Medicare Allowable Charges to 0.5%. Eligible providers who could have earned a $2,000 incentive in years past will bring in only $500 for their 2012 submissions. It may not be much, but it may offset much of the cost of the effort.

Second, there’s money to lose. It might seem that there are still three years until the penalty for not participating in PQRS starts in 2015. Medicare, of course, calls it an “adjustment”. 1.5% will be deducted from each and every Medicare Payment for services delivered after 1/1/2015. But that adjustment will be based on the failure to submit or the failure to qualify on a PQRS submission for the 2013 reporting year. 2012 is the last year to do a “dry run”. It’s the last year to test your systems before the failure to make a qualified PQRS submission translates into a financial penalty.

Third, your reputation is at stake. Medicare has begun building a public reporting infrastructure and wants to make comparisons of physician quality data available to the public. Medicare’s “Physician Compare” website is live at At the time of this writing, it is only a list of providers who provide care to Medicare patients. But there are plans to announce participation in PQRS and eRx reporting as indicators of better quality and later to publish actual performance levels. You are likely to see participation indicators as early as January 2013 and actual performance numbers within a year after that.

All-in-all, it’s a good time to get started on PQRS. There is a lot of good and productive work you can do whether you are still using a paper chart or have migrated to EHR. You can have an effective program if you are alone or in a large group.

While you’re at it, watch for my postings and don’t forget other CMS initiatives like

•  eRx

•  Meaningful Use

•  the Shared Savings Program

• the EHR incentive pilot

It’s not enough to be providing great care, in the emerging value-based healthcare world, you are going to have to prove it.

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